Usage
Cinchocaine + Policresulen is prescribed for the treatment of hemorrhoidal conditions (both internal and external), anal fissures, anal rhagades, incised or spontaneously perforated perianal thrombosis, anitis, cryptitis, anal eczema, pruritus, and postoperative wound treatment following proctological operations.
Pharmacological Classification: Policresulen is an antiseptic, hemostatic, and astringent; Cinchocaine is a local anesthetic.
Mechanism of Action: Policresulen selectively coagulates necrotic tissue, promoting its shedding while sparing healthy epithelium. It forms a protective film on the wound, constricts capillaries, and reduces bleeding, oozing, and itching. It also has a bactericidal effect. Cinchocaine provides local anesthetic action, relieving pain and itching associated with anorectal conditions.
Alternate Names
Faktu, Albothyl (policresulen alone), Polilen (policresulen alone, Taiwan).
How It Works
Pharmacodynamics: Policresulen acts locally on the affected tissue, causing coagulation of necrotic tissue and promoting healing. Cinchocaine blocks nerve impulse transmission, providing local anesthesia.
Pharmacokinetics: Policresulen: Limited systemic absorption (around 6-10%) after topical or rectal administration. Cinchocaine: Absorbed from mucous membranes, metabolized in the liver, and excreted primarily in the urine.
Mode of Action: Policresulen acts directly on the affected tissue. Cinchocaine blocks sodium channels in nerve membranes, preventing depolarization and nerve impulse propagation.
Receptor Binding, Enzyme Inhibition, or Neurotransmitter Modulation: Cinchocaine acts by blocking sodium channels. Policresulen’s mechanism doesn’t involve receptor binding, enzyme inhibition, or neurotransmitter modulation.
Elimination Pathways: Policresulen is minimally absorbed; any absorbed drug is likely excreted via the kidneys. Cinchocaine is metabolized in the liver and primarily excreted in the urine.
Dosage
Standard Dosage
Adults:
Ointment: Apply to the affected area 2-3 times daily. For rectal insertion, use the provided applicator after bowel evacuation.
Suppositories: Insert one suppository into the rectum 2-3 times daily, preferably after a bowel movement. Once symptoms improve, reduce to one suppository daily or as directed by the physician.
Children:
Not recommended for children under 12 years of age.
Special Cases:
- Elderly Patients: No specific dose adjustment is generally required, but careful monitoring is advised.
- Patients with Renal Impairment: No specific dose adjustment is indicated.
- Patients with Hepatic Dysfunction: No specific dose adjustment is indicated.
- Patients with Comorbid Conditions: Use with caution in patients with hypersensitivity to any of the components.
Clinical Use Cases
- Intubation: Not applicable.
- Surgical Procedures: Used postoperatively following proctological operations.
- Mechanical Ventilation: Not applicable.
- Intensive Care Unit (ICU) Use: Not indicated.
- Emergency Situations: Not applicable.
Dosage Adjustments: No specific dosage adjustments mentioned other than monitoring for elderly patients and those with hypersensitivity.
Side Effects
Common Side Effects:
Burning, itching at the application site.
Rare but Serious Side Effects:
Allergic reactions (including rash, swelling), anaphylaxis.
Long-Term Effects: No specific long-term effects reported.
Adverse Drug Reactions (ADR): Anaphylactic reactions, including skin reactions (angioneurotic edema, laryngeal edema, urticaria) and generalized reactions up to anaphylactic shock.
Contraindications
Hypersensitivity to policresulen, cinchocaine, or any of the excipients. Hypersensitivity to soy or peanuts (suppositories contain soy lecithin).
Drug Interactions
Concomitant use of other topical medications on the affected area may lead to local interactions. Therefore, other topical medications should not be used in the affected region during treatment with Cinchocaine + Policresulen. Interaction with anti-HIV drugs (ritonavir, cobicistat) should be considered.
Pregnancy and Breastfeeding
Pregnancy: Use only if clearly needed and after careful consideration of risks and benefits. Animal studies have not shown evidence of malformations, but human data is limited.
Breastfeeding: It is unknown whether cinchocaine or policresulen are excreted in human milk. Use with caution and consider potential risks to the infant.
Drug Profile Summary
- Mechanism of Action: Policresulen: antiseptic, hemostatic, astringent, promotes tissue regeneration. Cinchocaine: local anesthetic.
- Side Effects: Mild: burning, itching. Rare/Serious: allergic reactions, anaphylaxis.
- Contraindications: Hypersensitivity to components, soy, or peanuts.
- Drug Interactions: Avoid concomitant use of other topical medications on the affected area. Consider interaction with anti-HIV drugs.
- Pregnancy & Breastfeeding: Use with caution; limited data.
- Dosage: See detailed dosage section above.
- Monitoring Parameters: Observe for local reactions and signs of allergic reactions.
Popular Combinations
This medication is typically used as a fixed-dose combination of policresulen and cinchocaine.
Precautions
- General Precautions: Pre-screening for allergies, especially to soy or peanuts, is crucial.
- Specific Populations:
- Pregnant Women: Use only if clearly needed; weigh risks and benefits.
- Breastfeeding Mothers: Caution advised.
- Children & Elderly: Not recommended for children under 12. Caution in the elderly.
- Lifestyle Considerations: Alcohol should be avoided. Caution while driving is advisable until effects are known.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Cinchocaine + Policresulen?
A: Adults: Ointment: Apply 2-3 times daily; Suppositories: 1 suppository 2-3 times daily, reducing to once daily after symptom improvement. Children: Not recommended under 12 years.
Q2: What are the primary uses of this medication?
A: Hemorrhoids (internal & external), anal fissures, anal rhagades, anitis, cryptitis, anal eczema, pruritus, post-proctological surgery wound care.
Q3: What is the mechanism of action for each component?
A: Policresulen: antiseptic, hemostatic, astringent, promotes tissue regeneration. Cinchocaine: local anesthetic, blocks nerve impulse transmission.
Q4: Are there any serious side effects I should be aware of?
A: Yes, although rare, allergic reactions and anaphylaxis can occur. Seek immediate medical attention if these develop.
Q5: Can this medication be used during pregnancy or breastfeeding?
A: Use cautiously and only if the benefits outweigh the risks. Consult a specialist. Limited human data is available. It is not known if components are excreted in breast milk.
Q6: What should I do if a dose is missed?
A: Apply the missed dose as soon as remembered unless it is close to the next scheduled dose. Do not double the dose.
Q7: Are there any drug interactions I should be aware of?
A: Avoid concurrent use of other topical medications on the affected area. Interaction with anti-HIV medications should be considered.
Q8: Can I use this medication if I am allergic to soy or peanuts?
A: Suppositories contain soy lecithin. If you have soy or peanut allergy, inform your physician before use. Alternative formulations may be considered.
Q9: How should I store this medication?
A: Store at room temperature not exceeding 25°C.
Q10: What are the contraindications for Cinchocaine + Policresulen?
A: Hypersensitivity to any of the components. Hypersensitivity to soy or peanuts (for suppository formulations).
